Prehospital lactate analysis in suspected sepsis improves detection of patients with increased mortality risk: an observational study
Authors' conclusion
The addition of a prehospital lactate level > 3 mmol/l improved early recognition of individuals with increased mortality risk in a cohort with suspected sepsis admitted to the ED. This was particularly evident in patients whose risk stratification scores did not indicate severe illness.
Study context
- Population
- Adults with suspected sepsis, prehospital inclusion, admitted to the emergency departments (ED)322 (45%) met Sepsis-3
- Participants
- 714 adults
- Exposure
- Prehospital lactate added to Rapid Emergency Triage and Treatment System (RETTS) and NEWS2 risk stratification
- Outcome
- 30-day mortality
- Follow-up
- 30 days
Methodological detailsconsecutive prospective prehospital inclusion
- Consecutive prospective prehospital inclusion
Main finding
As reported in the abstract
Odds ratio
2.20
P = 0.009
Lactate > 3 mmol/l · multivariable regression
Prehospital lactate
2.6 vs 2.0 mmol/L
P < 0.001
Non-survivors vs Survivors
- Overall 30-day mortality
- 10%
- 30-day mortality among Sepsis-3 cases
- 14%
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Estimate | P value |
|---|---|---|
| 30-day mortality, RETTS non-red subgroup · 30 daysLactate > 3 mmol/l · multivariable regression | OR 3.02 | P = 0.009 |
| 30-day mortality, RETTS non-red subgroup · 30 daysNon-survivors vs Survivors | Prehospital lactate 2.4 vs 1.8 mmol/L | P = 0.002 |
| Prehospital lactate by RETTS priorityRETTS red vs RETTS non-red | Prehospital lactate 2.5 vs 1.9 mmol/L | P < 0.001 |
Identification of non-survivors when adding lactate > 3 mmol/l
- RETTS red group
- from 48 to 68%
- NEWS2 ≥ 7 group
- from 77 to 85%
Original publication
Prehospital lactate analysis in suspected sepsis improves detection of patients with increased mortality risk: an observational study. Crit Care. Published 21 January 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →